ALS_Case_hx - demyelinating disease, syphilis, on vitamin...

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A 51-year-old woman had gradual onset of difficulty speaking and swallowing. Physical examination showed diffuse hyperreflexia, hypertonia, diminished fine motor movement, mild muscle wasting, and occasional fasciculation. She could not elevate the soft palate and had markedly decreased tongue movement. Subsequently, difficulties in walking and in moving the hands developed. The clinical diagnosis was amyotrophic lateral sclerosis involving primarily the upper motor neurons. The results of serum and CSF studies were normal; no evidence of
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Unformatted text preview: demyelinating disease, syphilis, on vitamin B12 deficiency was found. Electromyography showed acute and chronic denervation with fasciculation; sensory conduction was normal. Cranial and upper cervical MR images were obtained and showed discrete bilateral abnormalities in signal in the anterior and lateral corticospinal tracts of the cervical cord could be identified; the cervical cord was mildly atrophic. The patient was subsequently lost to follow-up, and she did not return for further MR imaging of the spine....
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ALS_Case_hx - demyelinating disease, syphilis, on vitamin...

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